In a related editorial, Dr. David A. Asch, from the University of Pennsylvania’s Center for Health Care Innovation, Philadelphia, addressed the hidden economics of telemedicine. He told Reuters Health by email, “I think it is a trap to think that the only promise of telemedicine is the opportunity to do something remotely that used to happen face to face. The real opportunities will come from doing health care in a different way because of this remote technology.”
“An important question is, ‘If there are so many opportunities from telemedicine, why doesn’t more of it happen?'” Dr. Asch said. “I think there are a lot of reasons for that but one important reason is that insurers, in particular, worry that if they make telemedicine payments easy, then they will open up the floodgates of demand.”
Dr. Laura Markwick, from Wegmans School of Nursing, St. John Fisher College, Rochester, New York, told Reuters Health by email, “I would like to apply these to all health care providers and not just physicians. Of note, they do mention that they recommend a relationship already be established with the patient, which I do not feel is an absolute must. When we did our telemedicine program, we did not have a previous in-person relationship established and we were able to provide high-quality care that improved access for the patients.”
“All health care providers should be reimbursed for telemedicine care, at levels similar to what is reimbursed currently,” Dr. Markwick said. “This should be a covered service from the person’s insurance, depending upon the care needed. If it is just someone who does not feel like making it to an appointment but otherwise could with little difficulty (social issues included in this decision), then perhaps the patient should contribute toward this reimbursement.”
Dr. Manish N. Shah, from the University of Wisconsin School of Medicine and Public Health, Madison, told Reuters Health by email, “It is important to know that the U.S. is behind the rest of the world when it comes to telemedicine. In Canada, the Ontario Telemedicine Network has existed for years. In the UK, telemedicine has been also available.”
“Reimbursement for telemedicine is a complex issue, particularly because the entire provider payment system is changing,” Dr. Shah said. “However, without funding, telemedicine will not be made available to patients despite increasing evidence showing that patients want to use it, that care can be effectively delivered via telemedicine, and that telemedicine is cost effective.”
